Disclosure I have no relevant financial relationships with any - - PDF document
10/9/2019 Point of Care Ultrasound UCSF Continuing Medical Education Abdominal Imaging and Procedures Brandon Boesch, DO Disclosure I have no relevant financial relationships with any companies related to the content of this course. 1
10/9/2019 1 Point of Care Ultrasound UCSF Continuing Medical Education Abdominal Imaging and Procedures Brandon Boesch, DO
10/9/2019 2
3 Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier 4Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier
10/9/2019 3
5Curvilinear Phased Array
6 10/9/2019 4
7 10/9/2019 5
9Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier
10Normal Abnormal
10/9/2019 6
11Normal Abnormal
12Normal Abnormal
10/9/2019 7
13Normal Abnormal
14Normal Abnormal
10/9/2019 8
15Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier
16 10/9/2019 9
17 10/9/2019 10
19Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier
20 10/9/2019 11
21 22Abnormal Normal
Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier
10/9/2019 12
23Abnormal Normal
Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier
24 10/9/2019 13
2 Anatomical Sections ➔ Sonographic
“Double Density”
Renal Parenchyma = Cortex + Medulla Renal Sinus = Fatty tissue + Calyces +
Vessels
From Point-of-Care Ultrasound, 1st edition, 2014
10/9/2019 14
hyperechoic
pockets of urine (not contiguous) and vessels
gas
10/9/2019 15
Atrophy Hydronephrosis Stone Cysts Mass
10/9/2019 16
Mild = central dilation with preservation of
renal pyramids
Moderate = blunting of renal pyramids,
rounding of calices, “bear-claw” appearance, preservation of cortex
Severe = cortical thinning, calyceal
ballooning, distortion of architecture
From Point-of-Care Ultrasound, 1st edition, 2014
10/9/2019 17
From Point-of-Care Ultrasound, 1st edition, 2014
Indications
Estimate bladder volume Confirm catheter placement Ureteral obstruction (ureteral
Detect stones Work-up for renal failure
10/9/2019 18
Posterior and
Ureters enter
Prostate normally
From Point-of-Care Ultrasound, 1st edition, 2014
Longitudinal View Transverse View
10/9/2019 19 Normal Male Bladder
Transverse View
10/9/2019 20
Distended Bladder + Foley + Enlarged Prostate
Volume (ml) = 0.75 x width x length x height
Longitudinal View Transverse View
10/9/2019 21
From Point-of-Care Ultrasound, 1st edition, 2014
10/9/2019 22
From Point-of-Care Ultrasound, 1st edition, 2014
10/9/2019 23
From Point-of-Care Ultrasound, 1st edition, 2014
Celiac Trunk
10/9/2019 24
Celiac Trunk
Splenic Vein Celiac Trunk Aorta SMA
From Point-of-Care Ultrasound, 1st edition, 2014
10/9/2019 25
From Point-of-Care Ultrasound, 1st edition, 2014
Ao SMA Renal Arteries IVC Splenic Vein Vertebr al Body
From Point-of-Care Ultrasound, 1st edition, 2014
10/9/2019 26
Right and Left Common Iliac Arteries
From Point-of-Care Ultrasound, 1st edition, 2014
10/9/2019 27
From Point-of-Care Ultrasound, 1st edition, 2014
10/9/2019 28
transverse and longitudinal views
proximally (<2cm distally)
referral to vascular surgery
10/9/2019 29
From Point-of-Care Ultrasound, 1st edition, 2014
From Point-of-Care Ultrasound, 1st edition, 2014
10/9/2019 30
– NPO – Firm pressure or sweep transducer
– Fusiform – Saccular – (Pseudoaneurysm)
10/9/2019 31
61Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier
10/9/2019 32
63 10/9/2019 33
65Soni N., Arntfield R., & Kory P. (2015) Point-of-Care ultrasound. Philadelphia: Elsevier
66 10/9/2019 34
Lumbar Spine
at L1-L2 in adults
can be safely performed below L2
L1 L2 L3 L4 L5
10/9/2019 35
Transverse Plane Longitudinal Plane
Spinous Process Spinous Process Spinous Process Interspino us Space
Transverse Plane
10/9/2019 36
Transverse Plane
Longitudinal Plane
10/9/2019 37
10/9/2019 38
10/9/2019 39
processes can be mistaken for spinous processes
be seen superficial to spinous processes
Lamina / articular processes Erector spinae muscles
10/9/2019 40